Provider First Line Business Practice Location Address:
1423 NW MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98107-3744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-782-8688
Provider Business Practice Location Address Fax Number:
206-784-0585
Provider Enumeration Date:
11/07/2010